Tracheotomy instrument



Dec. 23, 1958 c. E. BROWN ET AL TRACHEOTOMY INSTRUMENT Filed Sept. 16, 1957 INVENTORS. (7/4/9159 5 BRO/WV fl/MO/V 5100/14 limited States l atent O TRACHEOTOMY INSTRUMENT Charles E. B;rown,'Sierra Madre,-and Aaron Blooni', Pasadena, Gallf assignors=to Sierra EngineeringlCm, Sierra Madre, Calif, 21 :corporationrof California Application September 16,1957, Serial No; 684,261

4 Claims. (Cl.' 128-'---305) The inventionrelatesto surgical instruments and. has particular reference to. an instrumentgenerally identified was a tracheotomy instrument which is designed for injection ,into.the trachea or windpipein ordertofacilitate breath- .ing inthe eventthe breathingmechanism at a location above the trachea and in'thesmouthor throat. prevents aadequate breathing. The invention is an -improvement ,upon; co-pending application Serial .No. 443,275, .filed :July 14,1954.

:.,.sult;on.,s ome.:occasions. of accidents where the surgical .goperatlon is performed as a first aid-operationv Because ofothe operation being necessary ofvperformance .under .n-thoseparticular circumstancesrthe skill of. a =surgical .-specia1ist is not always available and hence the instru- --ment-ofnecessityshould beone such that it isincapable ofimproper use-eventhough the administering physician 1 niightnot-be 1one ofjtlong experience in .this particular i-Certain improved ;tracheotomy .instruments .have recently beenydeveloped which .have furthered 'to a great degree-the etfectiveness of an operation of thetype-hereinumade-reference,to. U Even here, however inadequacies .have;bec.ome apparent through continued-use of they imwproved :linstruments -which have -rendered them .less

1 {effective than they; should be int-satisfying the; stringent need experienced in this field.

Itxis therefore among the-objects ofthe invention to ,rzprovide a, new andimproved tracheotomy instrument atwhich is' morespo-sitive in. the, handling thereby. to aimcproveathemapidity with whichthe operation can beeper- .wformed under circumstances other than those whichrpreavail; in the operatingzroom.

HAIIOlllluObjECi Ofulllfi. invention is;to;provide, a new wand improved tracheotomyainstrumentwhich isHsi-mpler in its structure totheextent: that itcan be manufactured win an .cflectivexform .withouttresort to close tolerances w and critical. manufacturing: technique; thereby: making the :instrument one which is less expensive.to manufacture.

Still anotherv object ofutheuinvention is. to.provide a :new. and improved tracheotomy. instrument which. is. so constructed thatzsirnplified. means. areemployed to secure .nthadifferentparts,ofthe instrument in initialpenetrating .rn'relationshipvand which ,moveover :improvessthe ease of 2,865,374 Patented Dec. 23, 1958 ice r withdrawal 'of'the knife from the tube after insertionof i the tube in the trachea, such that the keen edge ofthe knife-likeportions is not damaged during withdrawal.

It is j also among the objects of the invention to.pro-

Vide a-new and improved tracheotomy instrument of such design and construction that the'operating physician is afforded a greater degree of confidence and assurance in the handling of the instrument so that the operation wjcan- -besuccessfully and effectively performed with sub- .stantially. the greatest degree of rapidity and assurance.

With .theseHand other objects in view, the invention consists in the construction, arrangement andcombination of the various parts of the device, whereby the ob- I jects contemplated areWattained as hereinafter set forth and pointed out in the appended claims, and illustrated in the accompanying drawings.

.In the drawings:

.Fig. 1, is ajperspective view of the interior portion of the tracheotomy instrument.

Fig. 2. is a longitudinal sectional view of thecomplete tracheotomy instrument.

. Fig. 3 is a fragmentary longitudinal view partly broken away showing the operating end of the instrument.

.In .an embodiment of the invention chosen for, the purpose of.illustration there is shown a tracheotomy instrument whichin assembled form ready for insertion in the. trachea consistsof two essential parts, namely, a

curved tube 9 and an incisor assembly indicatedgenerally by thereference character10 and shown in Fig. 1.

.The .tube has .an operating end .11 and a handle end 12. =At ,the. operating end is a single slit 13. on the At the handle end is a flange 16 which extends laterally outwardly and preferably extends around all sides of the tube atthe perimeter ofwhich is an upturned, edge 16.

Locking pegs 17 are provided on the flange, the pegs .in; each instance having an undercut portion 18.

In Fig. 2 thetube is shown assembled with the incisor '10 in position inserted in the trachea 19 of a patient. As indicated, the tube, when inserted, extends between cartilage rings 20 after having pierced multiplelayers, of skin and tissue 21.

The incisor as shown consistsof a head 22 as indicated generally inFig. 1, the head comprising a body 23 and a neck-.24. The. neck is generally cylindrical. in shape and joins the body at one end. The body in turn has a shape somewhat like an olive seed, by wayof general description, and is equipped with a long knife or blade. 25; having portions 26 and Y26 on opposite sides of a center line, these portions being curved and terminating at the edges in a razor-like edge. A button 27. at

the tip of the blade protects the muscles and tissues at the'inside of the, trachea from inadvertent knickingsby .as shown extends for a substantial distance along the centerline'of the longiblade, andservessas aastiffening medium for the base portionsofzthe-longblade. Those portions ;of the. head 22. which accommodatethe blades may aptly bedefined as comprising along bowed portion -29 which extends along theoutside of the, curve. of

the long blade; and a shortbowed portionfillwhichex- 1 ;.tends on oppositevsidest of gthQ short -transverse,-;;knifeblade and lies against thebaselof.the,long blade.aathe inside ,ofthe curve.

At the. opposite end ofthe incisor is atknob .35 having a knurled exterior for ease in gripping. Within the knob is an axial central pocket 36. At the end of the knob which may appropriately be referred to as the inside end is a lock flange 37, having cut away straight sides or flat edges 38, the edges being formed to permit the lock flange to pass to a position beneath the lock pegs 1 7 at the area of the undercut 18 whereby upon rotation of the knob the wider portions of the flange 37 are adapted to engage beneath the lock pegs, thereby to anchor the incisor in the tube.

A pin 40 is adapted to be inserted through the outer portion of the knob 35 into an annular recess in a plug 41, formed between an inner disc 42 and an outer disc 43 at the area of an intermediate portion 45, the annular recess being identified by the reference character 44.

By making the recess 44 substantially wider than the diameter of the pin 4-0 the plug 41 is permitted to move for a substantial distance axially without binding against the pin.

A coiled compression spring 46 is located at the bottom of the pocket 36 and acts between the bottom of the pocket and the plug 41 in a direction normally urging the plug outwardly.

A rod 50 interconnects the head 22 with the plug 41. This rod although it may be slightly resilient by reason of its length and the character of material from which it is made is preferably set in its curvature to the degree of curvature illustrated and tempered so as to substantially maintain that curvature during use. It will be noted that the curvature of the rod is substantially the same as the curvature of the axis of the tube 9. To facilitate movement of the rod within the tube and correspondingly to facilitate movement of the head 22 into and out of the tube there is provided a spacer disc 51 having collars 52 by means of which the spacer disc is anchored to the rod at some selected distance intermediate opposite ends of the rod. The exterior circumference of the spacer disc is made of such size that it slides somewhat snugly, but nevertheless freely, within the interior wall 53 f the tube.

When the device is ready for use the incisor is inserted into the tube and locked in position by engagement of the lock flange 37 with the lock pegs 17. In this position the plug 41 exerts a pressure against the spring 46, the recess 44 having such width greater than the diameter of the pin 40 to permit a degree of movement in an axial direction without disturbing the freedom of rotation of the knob 35 with respect to the plug 41.

.In this assembled position the head 22 at the area adjacent the thickest cross-sectional area but on the outermost side thereof tends to bear against the end of the tube inside the edge 15. The end may be contracted very slightly inwardly in order to fix the limit of movement of the head. In this position the knife 3% lies opposite the slit 13 and the long knife portions 26 and 26 lie opposite the slits 14. By having the head fit snugly against the outer end no appreciable gap is left which otherwise might be prone to catch tissues as the razor-like edges of the knives are inserted through the tissues and between the cartilage rings during insertion of the instrument into the trachea.

Moreover, by reason of having the rod 50 of fixed curvature and due to the presence in part of the spacer disc 51, as the head is withdrawn upon release of the knob from the locking pegs, the knife edges will pass smoothly into the operating end of the tube 9 and will be prevented from catching upon adjacent portions of the tube in a manner which would nick or damage the razorlike edges of the blade. Furthermore, by providing a rod 50 of substantial stiffness and fixed curvature there is afforded to the instrument a firm feel in that there is no appreciable movement of one part with respect to the other. The effectiveness of the spring 46 may be very easily and readily controlled sufiieient to have it press firmly outwardly against the plug 41 and the rod 50,

thereby to firmly fix the head 22 in its proper assembled position while the incision is taking place.

Locking of the locking flange with respect to the locking pegs assists in creating a firmness of the inter-relationship of the parts sot that it has a sure and positive feel in the hands of the physician.

As previously suggested also when the incisor is to be withdrawn the withdrawal motion is smooth, rapid and positive, thereby greatly improving the high degree of insurance which the combination effects. The positive character of the instrument is such that those critical seconds which are so important in an operation of this type are saved, the saving of which may often prove the difference between a re-establishment of necessary breathing and complete cessation.

Having described the invention, what is claimed and sought to be secured by Letters Patent is:

1. A tracheotomy instrument comprising a hollow arcuate tube having an open operating end and an open handle end, a flange at said handle end having lock means thereon, a piercing assembly comprising a streamlined head having a pressure fit in said operating end and knife means on the head extendable beyond the tube, a knob having a lock means engageable with said first identified lock means, means forming an axially extending pocket in said knob, a plug slidably and rotatably secured in said pocket, an arcuate relatively stiff rod interconnecting said plug and said head, said rod in assembled position lying substantially along the axis of said tube, and a spacer disc fixed on said rod intermediate opposite ends thereof and having a sliding fit in said tube.

2. A tracheotomy instrument comprising a hollow arcuate tube having an open operating end and an open handle end, a flange at said handle end having lock pegs thereon, a piercing assembly comprising a streamlined head having a pressure fit in said operating end and knife means on the head extendable beyond the tube, a knob having a lock means engageable with said first identified lock means, means forming an axially extending pocket in said knob, a plug slidably and rotatably mounted in said pocket, an arcuate relatively stilf rod interconnecting said plug and said head, said rod in assembled position lying substantially along the axis of said tube, a spacer disc fixed on said rod intermediate opposite ends thereof and having a sliding fit in said tube, and a coiled spring between the bottom of said pocket and the plug biased in a direction pressing said plug, said rod and said head to a position wherein said head is pressed into the outermost end of said tube.

3. A tracheotomy instrument comprising a hollow arcuate tube having an open operating end and an open handle end, and a flange at said handle end having lock means thereon, a piercing assembly comprising a streamlined head having a pressure fit in said operating end and knife edges on the head extendable beyond the end of the tube, a knob having a lock means engageable with said first identified means, means forming an axially extending pocket in said knob, a plug slidably and rotatably mounted in said pocket, and cooperating means respectively in said knob and said plug retaining said plug rotatably in said pocket, an arcuate relatively stifi rod interconnecting said plug and said head, said rod in assembled position lying substantially along the axis of said tube, and a coiled spring between the bottom of said pocket and the plug biased in a direction pressing said plug, said rod and said head to a position wherein said head is pressed into the outermost end of said tube.

4. A tracheotomy instrument comprising a hollow arcuate tube having an open operating end and an open handle end, said operating end having a plurality of slits therein, and a flange at said handle end having lock pegs thereon, a piercing assembly comprising a streamlined head having a pressure fit in said operating end and knife edges on the head extendable through said slits,

5 a knob having a lock flange engageable with said pegs, means forming an axially extending pocket in said knob, a plug slidably and rotatably mounted in said pocket, and cooperating means respectively in said knob and said plug retaining said plug rotatably in said pocket, said means comprising an annular recess in the plug and a pin in the knob extending into said recess and of diameter substantially less than the breadth of the recess, an arcuate relatively stiff rod interconnecting said plug and said head, said rod in assembled position lying substantially along the axis of said tube, a spacer disc fixed 5 on said rod intermediate opposite ends thereof and having a sliding fit in said tube, and a coiled spring between the bottom of said pocket and the plug biased in a direction pressing said plug, said rod and said head to a position wherein said head is pressed into the outermost end of said tube.

References Cited in the file of this patent FOREIGN PATENTS 146,305 Germany June 25, 1936 

